Postoperative Protocol - Aorta-Bifemoral Bypass скачать в хорошем качестве

Postoperative Protocol - Aorta-Bifemoral Bypass

#AortaBifemoralBypass #PostoperativeProtocol #VascularSurgery #PatientRecovery #MAPManagement #FluidBalance #LabMonitoring This video details the Post-Aorta Bifemoral Bypass Protocol by Dr. Gregory Weir, outlining immediate postoperative patient management. A core focus is Mean Arterial Pressure (MAP) control, targeting 70-100 mmHg. *Key Protocol Elements:* *MAP Management:* MAP more than 100 mmHg: Titrate nitrosine. MAP less than 70 mmHg: Check Central Venous Pressure (CVP). CVP less than 10 cm H2O: Administer Ringer's lactate bolus (250 ml/hr). CVP more than 10 cm H2O: Titrate noradrenaline. *Monitoring & Support:* Oxygen mask use (if not intubated). Elevate legs to reduce edema. Maintain hematocrit (HTT) above 30%. Chest X-ray (CXR) to confirm CVP line placement. *Lab Tests:* Day 0: HTT, Troponin-T (TROPT). Day 1: Urea, Creatinine, Electrolytes (UKE), Full Blood Count (FBC), C-Reactive Protein (CRP), Myoglobin, TROPT. *Nutrition Progression:* Day 0: Nil per os (NPO). Day 1: Start feeding tube (e.g., Dobhoff 20 ml/hr) with Total Parenteral Nutrition (TPN) supplement. Day 2: Increase Dobhoff rate (40 ml/hr), decrease TPN rate (60 ml/hr). *Ventilation & Mobilization:* Day 0: Ventilate overnight. Day 1: Aim for extubation after morning rounds if stable; strict bed rest. Day 2: Begin gradual mobilization and sitting up (semi-Fowler position).